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Womens Health Issues. 2015 Nov-Dec;25(6):720-6. doi: 10.1016/j.whi.2015.06.008. Epub 2015 Aug 4.

Beliefs About Anal Cancer among HIV-Infected Women: Barriers and Motivators to Participation in Research.

Author information

1
Women's Health Unit, Section of General Internal Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts.
2
Women's Health Unit, Section of General Internal Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts. Electronic address: Christine.Gunn@bmc.org.
3
Department of Obstetrics and Gynecology, Boston University Medical Center, Boston, Massachusetts.
4
Division of Infectious Diseases and HIV Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania.
5
Department of Medicine, Baylor College of Medicine, Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.
6
Department of Radiation Oncology, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts.

Abstract

BACKGROUND:

Infection with the human immunodeficiency virus (HIV) remains associated with a greater risk of anal cancer, despite widespread use of combination antiretroviral therapy. Evidence concerning the acceptability of anal cancer screening gives little attention to women. Because HIV-infected women have a high prevalence of depression and history of sexual trauma, understanding acceptability among this group is critical.

PURPOSE:

We sought to assess barriers and motivators to participation in anal cancer screening research among a racial/ethnically diverse HIV-infected female population.

METHODS:

We conducted a survey based on the Health Belief Model to identify characteristics of women willing to participate in anal cancer screening research (n = 200). Bivariate analyses examined associations between willingness to participate and sociodemographics, clinical characteristics, and health beliefs. Logistic regression modeled willingness to participate in research.

MAIN FINDINGS:

Of the women who participated, 37% screened positive for depression, 43% reported a high trauma history, and 36% screened positive for posttraumatic stress disorder. Overall, 65% reported willingness to participate in research. Those likely to participate were older, reported intravenous drug use as their HIV risk factor, and had a history of prior high-resolution anoscopy (HRA) compared with those unwilling to participate. The most commonly reported barrier to anal Pap testing was fear of pain. In adjusted analyses, a lack of fear of pain and prior experience with HRA significantly predicted willingness to participate.

CONCLUSIONS:

Findings suggest that, to increase participation in anal Pap and HRA-related research for HIV-infected women, a single approach may not be adequate. Rather, we must harness patients' previous experiences and address psychosocial and financial concerns to overcome barriers to participation.

PMID:
26253825
PMCID:
PMC4641840
DOI:
10.1016/j.whi.2015.06.008
[Indexed for MEDLINE]
Free PMC Article

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